• Title/Summary/Keyword: 소아입원환자

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Inpatient Dental Consultations to Pediatric Dentistry in the Yonsei University Severance Hospital (연세대학교 세브란스 병원 내 입원한 환자의 소아치과 의뢰 현황)

  • Joo, Kihoon;Lee, Jaeho;Song, Jeseon;Lee, Hyoseol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.2
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    • pp.145-151
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    • 2014
  • The goal of this study was to describe dental consultation of pediatric inpatients to the department of pediatric dentistry at Yonsei University Severance Hospital. 391 dental consultations at Yonsei University Severance Hospital referred to pediatric dentistry in the year 2012 were included in this study. Consultations were categorized according to patients' gender, age, chief complaint, referred department and diagnosis. 288 patients (166 males and 122 females) with an average age of 5.9 were referred to the Department of Pediatric Dentistry. 129 cases (33.1%) from Department of Rehabilitation Medicine, 80 cases (20.5%) from Pediatric Hematology- Oncology, 51 cases (13.0%) from Pediatric Cardiology, and 44 cases (11.3%) from Pediatric Neurology. Chief complaints were ranked from oral examination (39.7%), dental caries (14.0%), pre-operative evaluation (12.8%) and others (33.5%); including oral pain, trauma, tooth mobility, orthodontic treatment, self-injury, fabrication of obturator and etc. Dental consultations should be encouraged as dental care and treatment could affect the control of systemic diseases of admitted patients. Pediatric inpatients have been referred to pediatric dentistry for not only comprehensive oral exam but also various chief complaints. The most frequent dental diagnosis made and treatment performed were dental caries and non-invasive/preventive care respectively.

Risk Factors of Readmission to Hospital for Pneumonia in Children (소아 폐렴의 재입원에 대한 위험인자)

  • Hong, Yu Chan;Choi, Eom Ji;Park, Sin-Ae
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.146-151
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    • 2017
  • Purpose: We analyzed the risk factors affecting readmission of children with pneumonia. Methods: We retrospectively analyzed the medical records of pediatric patients admitted to the Department of Pediatrics at the Jeonju Presbyterian Medical Center from January 2007 to August 2016. We classified patients who were readmitted with pneumonia within 30 days of discharge as the readmission group and patients who were admitted with pneumonia for the first time as the first admission group. Results: Among 158 patients, the study (readmission) group included 82 patients and the control (first admission) group included 76 patients. Age, the percentage of segmented neutrophils and lymphocytes, the number of admissions in the last 12 months, the associated diseases (respiratory diseases such as asthma), and the affection of the right upper lung were analyzed as risk factors for readmission. However, based on a regression analysis, only age and associated diseases were found to be significant risk factors. The rate of readmission increased with younger age. When there were associated diseases, the rate of readmission also increased. Conclusions: Young age and associated diseases were significant risk factors for readmission for patients with pediatric pneumonia. When pediatric patients are admitted with pneumonia, if they are young and/or have associated diseases, a comprehensive approach is needed to reduce the rate of readmission with careful consideration of precise examination, treatment, timing of discharge, and follow-up.

Consultations to Department of Dentistry for Child and Adolescent Inpatients with Dental Trauma (치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰)

  • Jo, Chanwoo;Kim, Jihun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.4
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    • pp.403-411
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    • 2017
  • The purpose of this research is analyzing present condition, and pursuing developmental direction of consultation to department of dentistry for medical inpatient with dental trauma. This research conducted a retrospective analysis of consultation to department of dentistry for medical inpatient at Wonju Severance Christian Hospital from March 2011 to February 2017. This research analyzed chief complaint and dental diagnosis, referring department, time of consultation after dental trauma, relation between hospitalization period and time of consultation after dental trauma, relation between dental trauma and admission in the medical department due to trauma, cause and age of dental trauma occurrence, treatment of dental trauma, and revisiting rate of inpatient with dental trauma after discharge. Among all the chief complaint and dental diagnosis, dental trauma was the highest. Among all the referring departments, departments of surgery were the highest. In relation to being delayed of consultation term after dental trauma, it turned out that there's pretty high mutual relation between the hospitalization period and the consultation term after dental trauma, and the hospitalization period had the quantitative influence on the consultation term. Statistically, dental trauma and admission in the medical department due to trauma had significant relations. In case of those patients due to car accidents, they had dental trauma without exception. Statistically, patient's group with dental trauma in hospital room was younger than patient's group with dental trauma in non-hospital room. Statistically, dental trauma and treatment in hospitalization had no significant relations, and dental trauma and revisiting department of dentistry after discharge had no significant relations. For the child and adolescent inpatients hospitalized for car accidents, there is high possibility of accompanying dental trauma, and dental consultations can be delayed. For the young child inpatients, the possibility of dental trauma occurrence in hospital room is high. Moreover, treatments during hospitalization and revisiting department of pediatric dentistry after discharge are not performed well for inpatients with dental trauma. Regarding these results, it can be an alternative that improving of consultation system, dedicated workforce placement and having dental facilities and equipment in the hospital ward, education to medical doctor and dentist, communication between medical doctor and dentist. This research can be used as a study material of medical and dental departments, and it's expected to be committed to developing of consultations to department of dentistry for child and adolescent inpatients with dental trauma.

Dental Consultations and Treatment Pattern of Pediatric Inpatient in Severance Hospital (세브란스 병원에 입원한 환자들의 소아치과 협진의뢰 내용 및 진료현황)

  • Song, Jihyeo;Lee, Koeun;Song, Je Seon;Kim, Seong-Oh;Lee, Jaeho;Choi, Hyung-jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.2
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    • pp.200-208
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    • 2019
  • The purpose of this study was to analyze the dental consultation of pediatric inpatients to the department of pediatric dentistry in Yonsei University Severance Hospital, and to investigate the change in patterns. In 2017, 268 pediatric patients (384 cases) admitted to the Severance Hospital were referred to the department of pediatric dentistry. The mean age was 6.6 years, and most of the patients were referred from the Department of Pediatric Hematology Oncology and Rehabilitation Medicine. The chief complaints were as follows: oral examination (31%), dental caries (20%), oral pain (10%), tooth mobility (10%), pre-operative evaluation (9%) and others (20%). 41% of the patients received only oral examination without treatment. Dental caries were the most frequent dental diagnosis of the patients. 28% (111 cases) of patients received operative treatments, 22 cases were treated under general anesthesia. Oral health is closely related to systemic diseases, especially for hospitalized patients. Dental consultations should be encouraged for prevention and early appropriate treatments. For this purpose, it is necessary to establish a referral system and perform dental treatment under general anesthesia.

Trends of hospitalized tuberculosis at a children's hospital during a 20-year period (1988-2007) (20년간(1988-2007) 1개 대학병원에 입원한 소아결핵 환자의 동향)

  • Yang, Mi Ae;Sung, Ji Yeon;Kim, So Hee;Eun, Byung Wook;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.59-67
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    • 2008
  • Purpose : According to the 2008 WHO report, incidence, prevalence, and mortality of tuberculosis are decreasing globally. The 7th National Tuberculosis Survey of 1995 in Korea showed that the prevalence of tuberculosis was also decreasing. This study was performed to review the hospitalized childhood tuberculosis in a children's hospital over a 20 year period. Methods : Medical records of children <16 years of age hospitalized with the diagnosis of tuberculosis at the Seoul National University Children's Hospital between 1988 and 2007 were reviewed retrospectively. Changes in number of patients and involved sites were also analyzed by four 5-year periods. Results : Out of the 186 hospitalized patients, 59.1% were male. Median age at diagnosis was 5.5 years old (range, 10 days-15 years). The main involved sites included the lung (n=54, 29%) or pleura (n=12, 6.5%), central nervous system (n=49, 26.3%), lymph node (n=15, 8.1 %), bone and joint (n=9, 4.8%), gastrointestinal tract (n=5, 2.7%) or peritoneum (n=5, 2.7%), pericardium (n=2, 1.1%) and others (n=3, 1.6%). Total 32 patients (17.2%) showed miliary pattern. The proportion of hospitalization with newly diagnosed tuberculosis among all cause hospitalization decreased from 0.61% to 0.09%, comparing the period of 1988-1992 and 2003-2007 (P<0.001) and the incidence of hospitalized tuberculosis of any involved organs also decreased with a statistical significance. Conclusion : The data from a single children's hospital suggest that the number of hospitalized childhood patients with tuberculosis has decreased over a 20 year period in Korea.

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A Retrospective Analysis of Use in Hospitalized Children with Upper Respiratory Tract Infection (상기도 감염으로 입원한 소아환자에서 항생제 사용에 대한 후향적 분석)

  • Jung, Minyoung;Park, Ji Hyun;Oh, Chi Eun
    • Pediatric Infection and Vaccine
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    • v.24 no.2
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    • pp.87-94
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    • 2017
  • Purpose: The inappropriate prescription of antibiotics in children with upper respiratory tract infection (URTI) is common. This study evaluated the factors that influence antibiotics use in hospitalized children with viral URTI confirmed by reverse transcriptase-polymerase chain reaction (RTPCR) assay. Methods: The medical records of admitted patients who performed RT-PCR assay for respiratory virus pathogens from January 2013 to November 2014 were examined. The demographic and clinical features were compared between patients who were administered antibiotics at admission and those who were not. We also investigated differences between children who continued antibiotics and those who stopped antibiotics after a viral pathogen was identified. Results: In the total 393 inpatients, the median age was 23 months (interquartile range, 13 to 41.3 months). Antimicrobial agents were prescribed in 79 patients (20.1%) at admission. Patients with acute otitis media (AOM) had higher rates of antibiotics prescription than those without AOM (48.1% vs. 2.2%, P<0.001), with an adjusted odds ratio of 91.1 (95% confidence interval, 30.5 to 271.7). Level of high-sensitivity C-reactive protein and the proportion of acute rhinosinusitis were also significantly associated with antibiotics use (P<0.001). Among the 44 patients with viruses identified using the RT-PCR method during hospitalization, antibiotic use was continued in 28 patients (63.6%). AOM was statistically associated with continued antibiotic use in the patients (P=0.002). Conclusions: Although the respiratory virus responsible for URTI etiology is identified, clinicians might not discontinue antibiotics if AOM is accompanying. Therefore, careful diagnosis and management of AOM could be a strategy to reduce unjustified antibiotic prescriptions for children with URTI.

Common Disease Codes in Pediatric Inpatients (1997-2008) (소아청소년과 입원환자의 흔한 질병 코드들(1997-2008): 감염질환 중심의 단일기관 연구)

  • Park, Ji-Eun;Lee, Soo-Young;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.54-60
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    • 2011
  • Purpose : In this study, we listed common diseases in pediatric inpatients and evaluated the distribution of diseases by period and age group, in order to estimate the epidemiologic trend. Methods : Patients who were admitted to the Department of Pediatrics between 1997 and 2008 were included. Demographic characteristics, date of admission, and International Classification of Diseases (ICD) code of patients were indentified. Study period was divided into two; early (1997-2002) and late (2003-2008), and age of patients were grouped into four; infancy, early childhood, late childhood, and adolescence. Results : A total of 33,513 patients were admitted for 12 years. In the list of ICD code, Pneumonia (J12-J18; 21.2%) was the most prevalent, followed by gastroenteritis (A00-A09; 17.8%), bronchiolitis (J21; 11.9%), and so on. Common diseases ranked from 1 to 10 comprised the majority (79.1%) of all the inpatients. There was increase in the number of inpatients with respiratory infectious disease (bronchiolitis, otitis media, and sinusitis), enlarged lymph node, or impetigo/cellulitis, but decrease in the number of inpatients with aseptic meningitis, intussusceptions, measles, or nephritic/nephrotic syndrome. The distribution of diseases also showed age group-specific difference. Conclusion : The distribution of diseases by period and age group was different. The epidemiologic trend should be considered in developing the management of strategy for the Department of Pediatrics.

A Study on the Factors that Influence the Surgical Outcomes of Choledochal Cyst in Children (소아에서 담관 낭종의 수술 성적에 영향을 주는 요인에 대한 연구)

  • Kim, Jong-Kyu;Noh, Gyoung Tae;Min, Seok-Ki;Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.18 no.1
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    • pp.1-11
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    • 2012
  • 담관 낭종은 흔하지는 않지만, 외과적 절제가 필요한 주요 질환이다. 절제하지 않고 남겨두면 다른 질환으로의 이환이나 다양한 합병증에 의한 사망까지도 야기할 수 있기 때문에 적절한 수술적 치료가 필수적이다. 최근 수술에 따른 다양한 문제들이 계속 보고되고 있으며, 출생 전이나 건강 검진 시 발견되는 무증상의 담관 낭종의 수술 시기에 대해서도 아직 논란이 되고 있다. 저자들은 1995년부터 2009년까지 담관 낭종으로 수술 받은 환자 중 수술 받을 당시의 연령이 18세 이하인 32명 환자의 임상 양상과 수술 기록을 후향적으로 분석하여, 수술 성적에 영향을 주는 요인들을 알아보고자 하였다. 전체 32명 중 남자 10명, 여자 22명이었으며, 수술 당시의 평균 연령은 5.4세였다. 췌담관 합류이상은 9명(28.1%)이었으며, 평균 추적 관찰 기간은 34.6개월이었다. 술 전 증상을 호소한 환자는 30명(93.8%)이었으며, 복통(63.3%), 황달(40.0%), 구토(23.3%), 복부종물(16.7%), 발열(16.7%)등의 순서였다. 술 전 혈액 검사에서 AST/ALT의 상승이 18명(56.3%), 고빌리루빈혈증이 8명, 백혈구 증가증이 7명(21.9%)이었다. 술 후 합병증은 5명(15.6%)에서 나타났는데, 2명은 담관염이었고, 나머지 3명은 문합부 협착, 술 후 출혈, 장 폐쇄가 각각 1명 있었다. 술 후 평균 재원 기간은 12.2일 이었으며, 추적 관찰 기간 중 3명(9.0%)이 재입원 하였다. 수술 성적에 영향을 미치는 요인으로, 수술 당시의 나이가 많을수록 평균 수술 시간과 재원 기간이 증가하였다(p=0.004, p=0.028). 증상이 있었던 환자군에서 무증상 환자군보다 재원 기간이 더 길었다(p=0.001). 또한 췌담관 합류이상이 있었던 환자군에서 재입원율이 유의하게 높았다(p=0.005). 소아의 담관 낭종은 진단이 되면 증상 발현 전이라도 조기에 수술하는 것이 수술 시간 및 재원 기간을 단축시킬 수 있으며, 췌담관 합류이상이 동반된 경우에는 술 후에 재입원할 가능성이 높으므로 주의깊게 추적 관찰하는 것이 바람직할 것이다.

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The Changes in the Outbreak of Rotavirus Gastroenteritis in Children after Introduction of Rotavirus Vaccines: A Retrospective Study at a Tertiary Hospital (로타바이러스 백신 도입 후 로타바이러스 위장관염의 추이: 일개 3차 병원의 후향적 연구)

  • Park, Dong Kyu;Chung, Ju-Young
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.167-173
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    • 2014
  • Purpose: This study aimed to examine the changes in the outbreak of acute gastroenteritis, rotavirus gastroenteritis after the introduction of the rotavirus vaccine in Korea. Methods: The current study investigated the number of inpatients in the pediatric ward of Inje University Sanggye Paik Hospital during the periods of 2005-2006 and 2011-2012. A retrospective analysis was conducted on the medical records of 2,840 patients <5 years of age who were hospitalized at Inje University Sanggye Paik Hospital in these time periods. Results: When we compared 2 separate sets of data from before (2005-2006) and after (2011-2012) vaccine introduction, there were statistically significant decreases in the number of patients who were hospitalized for acute gastroenteritis across all of the groups of patients <5 years of age except those <2 months of age. The number of patients with rotavirus gastroenteritis in all age groups declined except for children <2 months of age and those 2-5 months of age. Conclusion: These results show that after the introduction of a rotavirus vaccine in Korea, the incidence of rotavirus gastroenteritis decreased in 6-59-month-old patients hospitalized for acute gastroenteritis.